About Those Death Panels

By Shawn Kennedy, AJN editor-in-chief

Diana Mason, former editor-in-chief of AJN, wrote a post on July 9 on the JAMA Forum blog that’s well worth reading. In it, she talks about the resurgence of “death panels” rhetoric to stir opposition to the Affordable Care Act (ACA), specifically in relation to the Independent Payment Advisory Boards, which are to issue binding recommendations for controlling costs if Medicare grows too rapidly.

In a nutshell, these boards will determine where to reduce costs. If Congress opposes the plan, it will have to come up with same-size cost cuts if it doesn’t want to institute what the board recommends. The message that opponents of the ACA want the public to hear is that their fates will be determined not by them but by an arbitrary committee.

But IPABs are about reducing costs of programs, not passing judgment on individuals.  (As Mason notes, the death panel rhetoric was “declared the “2009 Lie of the Year” by PolitiFact, a project of the Tampa Bay Times and partner news organizations.”)

People should have conversations about how they wish to be treated in their last moments, but these should occur with loved ones and direct care providers and be supported by the legal system. People shouldn’t have to worry that they will be rushed along to death if they’re not ready—in fact, this seems […]

2018-03-28T10:36:14-04:00July 18th, 2012|health care policy|5 Comments
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The Affordable Care Act Survives, At Least for Now

Shawn Kennedy, AJN editor-in-chief

Senate roll call, Affordable Care Act/by Kurykh, via Wikimedia Commons

It’s been a couple of weeks now since the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA), and there have been too many articles and analyses to count. The bottom line is that its fate won’t be settled until after the November elections. If the Republicans win the election, the ACA will become the first battleground, as its repeal has been promised by candidate Mitt Romney.

What is concerning is that a great many people pay attention to the rhetoric rather than finding out the facts (remember “death panels”?). This point was well made by political cartoonist Stuart Carlson in this cartoon. It’s hard not to be in favor of many of the provisions—like extending coverage under a parent’s plan for children up to 26 years of age, or barring insurance companies from denying coverage for preexisting conditions.

As nurses, we need to know the facts and go beyond the political rhetoric. We need to be informed for ourselves (anything that has an impact on health care delivery and funding will affect nursing) and for our patients, who will have questions. Get the facts—read the law at the link above, a summary of the law, or the articles we published summarizing how it will affect nursing (our original article, and a 2011 update, both open access until […]

2016-11-21T13:09:43-05:00July 9th, 2012|health care policy, nursing perspective|2 Comments
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Forward or Back? Some Personal Notes on Why the Affordable Care Act Matters

By Jacob Molyneux, senior editor/blog editor

So today the U.S. Supreme Court did something a little surprising in upholding the individual mandate provision in the Affordable Care Act (here’s the text of the full decision). It was the right thing to do, given judicial precedent, but it still comes as a surprise that Chief Justice Roberts was the swing vote rather than Kennedy, or that they actually did this. Justice Roberts must have looked to his conscience and seen how history would judge him. Or it’s nice to think so.

This is good for many reasons: those under 26 on their parents’ plans can now stay there. A bunch of money earmarked for nurse education will not suddenly disappear. Health care exchanges holding insurance companies to minimum standards will be implemented. Accountable care organizations can continue to experiment in an effort to replace the disastrously expensive fee-for-service model with one tied more closely to outcomes. And a great deal more.

But now we should ask ourselves: Do we go forward or back? This is the real question when it comes to the American health care system. Going back isn’t an option, though many are sure to go on pretending it is (the Republicans will make repealing the Affordable Care Act a […]

2016-11-21T13:09:47-05:00June 28th, 2012|health care policy, nursing perspective, Patients|9 Comments
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Early Spring Web Roundup: Insomnia, Early Delivery, Persistence, Painkillers, Overtesting

We’ve been a little quiet here on the blog this week. Maybe it has to do with the opening of baseball season or signals a hangover from media coverage of the Supreme Court give-and-take about the Affordable Care Act last week and the endless guesses about how the court is likely to vote come June. Or maybe all our nurse bloggers are using spare time to clean out closets, sweep the cherry blossoms and sale inserts from the sidewalk, purge the inbox, box up the humidifier, watch Mad Men, or whatever. But here are a few things we’d like to draw your attention to:

If the windy spring nights wake you (or your patients) to the sound of a trash can lid flying away, maybe this will help: As described in the Drug Watch column in AJN‘s April issue, a sublingual form of the drug zolpidem (think Ambien) has now been approved, with the fancy name Intermezzo, for people who wake in the middle of the night and start hearing the same song over and over in their heads or thinking of the perfect comeback to that snippy waiter.

Also in the April issue, an AJN Reports looks at efforts to get people not to opt for potentially risky early delivery of their babies, and a Reflections essay called

2016-11-21T13:10:21-05:00April 6th, 2012|health care policy, nursing perspective|0 Comments
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The Affordable Care Act on Trial

By Maureen Shawn Kennedy, MA, RN, editor-in-chief

According to the National Conference of State Legislatures, 47 states have enacted some legislation to block or limit various requirements of the Affordable Care Act (ACA). And a week from Monday, on March 26, the Supreme Court will begin hearings on the constitutionality of the law, as 26 states bring suit against the federal government. The primary issue for the Court: can the federal government mandate that individuals must purchase health insurance?

Other closely related issues the court has also set aside time to consider are whether other provisions of the law can still be implemented or must be voided if the individual mandate is struck down, the legality of the proposed Medicaid expansion, and whether the court must in fact wait until the individual mandate is actually implemented in 2015 before even considering its legality.

So how do many Americans feel? The Kaiser Family Foundation has been tracking opinions on the law and offers an excellent interactive chart that shows opinions according to different variables, including age, income, political party affiliation, gender, and current insurance status. Their findings may surprise you.

For more information about the Affordable Care Act and it implications for nursing, here are some links to AJN’s coverage since it was signed into law in 2010:

“Nurses and the Affordable Care Act,” Mary Wakefield
“What Future for the Affordable Care Act,” Diana Mason
“Health Care Reform and a System […]

2016-11-21T13:10:29-05:00March 16th, 2012|health care policy|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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